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Bae Y. Younger Older Americans and Sarcopenic Obesity: The Moderating Role of Living Alone. J Gerontol B Psychol Sci Soc Sci 2024; 79:gbae117. [PMID: 39001662 PMCID: PMC11308196 DOI: 10.1093/geronb/gbae117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Indexed: 08/10/2024] Open
Abstract
OBJECTIVES Previous studies have indicated that compared to older adults, younger older adults (e.g., baby boomers) are more susceptible to obesity, but their risk decreases as they age. However, there is a lack of research on how individuals experience sarcopenic obesity, which increases in later life and is a mortality risk factor. This study examined how younger cohorts of older Americans and their demographic traits are related to sarcopenic obesity. METHODS Generalized estimating equations were used to analyze participants aged 65 years and older, stratified by sex using data from the 2006-2016 Health and Retirement Study, with survey weights (n = 2,896 men and n = 4,268 women). RESULTS The findings indicate that the youngest cohort (born between 1948 and 1953) had greater odds of sarcopenic obesity than older cohorts (born before 1931). However, the youngest cohort did not have significantly different risks from those born between 1931 and 1947. Unexpectedly, the youngest cohort of older women living alone tended not to have sarcopenic obesity compared to the older cohorts living alone. These results remained significant even after adjusting for various covariates, including marital status, race, education level, wealth, and other factors. DISCUSSION This paper contributes to the existing literature on population health and demographic change in 2 ways. First, the risk of sarcopenic obesity is higher among younger cohorts of older Americans relative to older cohorts (born before 1931). Second, living alone may not necessarily be considered a worse health condition, particularly for younger female cohorts.
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Affiliation(s)
- Youngjoon Bae
- Population Research Center, The University of Texas at Austin, Austin, Texas, USA
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King LM, Barnett TE, Allen AC, Maizel JL, Wilson RE. Tobacco-related health inequalities among Black Americans: A narrative review of structural and historical influences. J Ethn Subst Abuse 2024; 23:381-411. [PMID: 35839212 DOI: 10.1080/15332640.2022.2093812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
We conducted a narrative literature review to examine contributing factors of disparities in tobacco usage and outcomes affecting Black Americans. We propose potential solutions that can be used to effectively address these disparities. We identified historical factors; socioeconomic factors; targeted marketing/advertising; the influence of racism/discrimination; neighborhood socioeconomic disadvantage; and mass incarceration. We call for more thorough examinations of these factors as a key element of tobacco-focused research and interventions to eliminate the disproportionate burdens faced by Black Americans. We advocate for greater emphases on the impacts of personal and structural racism on tobacco usage and outcomes affecting Black Americans.
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Affiliation(s)
| | - Tracey E Barnett
- University of North Texas Health Science Center at Fort Worth, Fort Worth, Texas
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Zheng H, Choi Y. Reevaluating the "deaths of despair" narrative: Racial/ethnic heterogeneity in the trend of psychological distress-related death. Proc Natl Acad Sci U S A 2024; 121:e2307656121. [PMID: 38315821 PMCID: PMC10895366 DOI: 10.1073/pnas.2307656121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 11/02/2023] [Indexed: 02/07/2024] Open
Abstract
Despite the significant scientific advancement in deciphering the "deaths of despair" narrative, most relevant studies have focused on drug-, alcohol-, and suicide-related (DAS) deaths. This study directly investigated despair as a determinant of death and the temporal variation and racial heterogeneity among individuals. We used psychological distress (PD) as a proxy for despair and drew data from the US National Health Interview Survey-Linked Mortality Files 1997 to 2014, CDC (Centers for Disease Control and Prevention) Multiple Cause of Death database 1997 to 2014, CDC bridged-race population files 1997 to 2014, Current Population Survey 1997 to 1999, and the American Community Survey 2000 to 2014. We used Cox proportional hazards models to estimate mortality hazard ratios of PD and compared age-standardized PD- and DAS-related mortality rates by race/ethnicity and over time. We found that while Whites had a lower prevalence of PD than Blacks and Hispanics throughout the whole period, they underwent distinctive increases in PD-related death and have had a higher PD-related mortality rate than Blacks and Hispanics since the early 2000s. This was predominantly due to Whites' relatively high and increasing vulnerability to PD less the prevalence of PD. Furthermore, PD induced a more pervasive mortality consequence than DAS combined for Whites and Blacks. In addition, PD- and DAS-related deaths displayed a concordant trend among Whites but divergent patterns for Blacks and Hispanics. These findings suggest that 1) DAS-related deaths underestimated the mortality consequence of despair for Whites and Blacks but overestimated it for Hispanics; and 2) despair partially contributed to the DAS trend among Whites but probably not for Blacks and Hispanics.
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Affiliation(s)
- Hui Zheng
- Department of Sociology, Institute for Population Research, The Ohio State University, Columbus, OH43210
- Department of Sociology, Research Hub of Population Studies, The University of Hong Kong, Hong Kong SAR
| | - Yoonyoung Choi
- Department of Sociology, Institute for Population Research, The Ohio State University, Columbus, OH43210
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4
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Odd DE, Stoianova S, Williams T, Odd D, Edi-osagie N, McClymont C, Fleming P, Luyt K. Race and Ethnicity, Deprivation, and Infant Mortality in England, 2019-2022. JAMA Netw Open 2024; 7:e2355403. [PMID: 38345821 PMCID: PMC10862146 DOI: 10.1001/jamanetworkopen.2023.55403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 12/18/2023] [Indexed: 02/15/2024] Open
Abstract
Importance England has one of the highest infant mortality rates in Europe. Much of the variation in infant mortality rates between races and ethnicities may be due to socioeconomic factors, but how deprivation and race and ethnicity are associated with infant mortality is unclear. Objectives To investigate the association of infant race and ethnicity with the infant mortality rate in England, adjusted for preterm birth and level of deprivation. Design, Setting, and Participants This cohort study included children who died younger than 1 year of age, born at or after 22 weeks' gestation, occurring from April 1, 2019, to March 31, 2022, in England. Characteristics of the infant were derived from death notifications. Exposures The racial and ethnic groups were derived from National Health Service data and were reported by the parents and characterized using the Office of National Statistics classification: Asian or Asian British (Bangladeshi, Chinese, Indian, Pakistani, or any other Asian background), Black or Black British (African, Caribbean, or any other Black background), multiracial (White and Asian, White and Black African, White and Black Caribbean, or any other multiracial background), White or White British (British, Irish, any other White background, or Gypsy or Irish Traveler), and other (Arab or any other racial or ethnic group). Main Outcomes and Measures Risk of death for all racial and ethnic groups and relative risk of death compared with the reference group (White) were calcuated. Analyses were repeated, adjusting for deprivation, gestational age of infants, and region of England. Results A total of 5621 infants who died younger than 1 year of age were reported to the National Child Mortality Database. A total of 2842 of 5130 infants (55.4%) were male; the median gestational age was 33 weeks (IQR, 25-38 weeks); of 5149 infants, 927 (18.0%) were Asian, 448 (8.7%) were Black, 3318 (64.4%) were White, 343 (6.7%) were multiracial, and 113 (2.2%) were from other racial and ethnic groups; and the median deprivation score was 4 (IQR, 3-5). In the unadjusted analysis, the relative risk of death compared with White infants was higher for Black (1.93 [95% CI, 1.75-2.13]) and Asian (1.67 [95% CI, 1.55-1.80]) infants. The population attributable risk fraction for all mortality rates among infants who were not White was 12.0% (95% CI, 10.3%-13.8%) (unadjusted), 9.8% (95% CI, 8.0%-11.7%) (adjusted for deprivation), 7.7% (95% CI, 5.9%-9.5%) (adjusted for gestational age at birth), and 12.8% (95% CI, 11.0%-14.5%) (adjusted for region of England). Conclusions and Relevance This cohort study suggests that the proportion of infants who died before 1 year of age is associated with race and ethnicity, with a population attributable risk fraction of 12.0%. An overconservative adjustment for deprivation did not explain the overall patterns seen. Approximately half the population attributable risk fraction may be due to increased risk of preterm birth in Asian and Black communities. Work is needed to identify what can be done to reduce this incidence of infant mortality.
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Affiliation(s)
- David E. Odd
- Division of Population Medicine, School of Medicine, University of Cardiff, Cardiff, United Kingdom
- National Child Mortality Database, Bristol Medical School, University of Bristol, St Michael’s Hospital, Bristol, United Kingdom
| | - Sylvia Stoianova
- National Child Mortality Database, Bristol Medical School, University of Bristol, St Michael’s Hospital, Bristol, United Kingdom
| | - Tom Williams
- National Child Mortality Database, Bristol Medical School, University of Bristol, St Michael’s Hospital, Bristol, United Kingdom
| | - Dawn Odd
- School of Health and Social Wellbeing, University of the West of England, Blackberry Hill, Bristol, United Kingdom
| | - Ngozi Edi-osagie
- Newborn Intensive Care Unit, Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | | | - Peter Fleming
- National Child Mortality Database, Bristol Medical School, University of Bristol, St Michael’s Hospital, Bristol, United Kingdom
| | - Karen Luyt
- National Child Mortality Database, Bristol Medical School, University of Bristol, St Michael’s Hospital, Bristol, United Kingdom
- The National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West) at University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, United Kingdom
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5
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Zheng H, Dirlam J, Choi Y, George L. Understanding the health decline of Americans in boomers to millennials. Soc Sci Med 2023; 337:116282. [PMID: 37832317 DOI: 10.1016/j.socscimed.2023.116282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 07/30/2023] [Accepted: 09/26/2023] [Indexed: 10/15/2023]
Abstract
Morbidity and mortality are on the rise among Americans from Boomers to Millennials. We investigate early-life diseases and the socioeconomic, psychosocial, and bio-behavioral factors behind this worsening health trend. Using data from the Panel Study of Income Dynamics Family and Individual Files 1968-2013, we find that the chronic disease index and poor subjective health have continuously increased for Baby Boomers and later cohorts. Early-life diseases, obesity, and shortening job tenure account for about half the health decline across cohorts. Weakening union protection, decreasing marriage, and declining religion only make minor contributions. All other factors, including early life nutrition and family background, adulthood socioeconomic status, physical activity, and smoking behaviors, make negative or non-significant contributions. These findings highlight that even though recent cohorts have better childhood nutrition, family socioeconomic environment,and higher levels of education and income, these advantages have been offset by elevated early-life disease exposure, obesity, and a precarious labor market. We discuss the findings in the context of Case and Deaton's "cumulative deprivation" thesis.
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Affiliation(s)
- Hui Zheng
- Ohio State University, United States; The University of Hong Kong, China.
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6
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Zang E, Sobel ME, Luo L. The mobility effects hypothesis: Methods and applications. SOCIAL SCIENCE RESEARCH 2023; 110:102818. [PMID: 36796994 PMCID: PMC9936082 DOI: 10.1016/j.ssresearch.2022.102818] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 10/20/2022] [Accepted: 10/21/2022] [Indexed: 06/18/2023]
Abstract
We discuss hypotheses researchers have put forth to explain how outcomes of socially mobile and immobile individuals might differ and/or how mobility experiences are related to outcomes of interest. Next, we examine the methodological literature on this topic, culminating in the development of the diagonal mobility model (DMM, also called the diagonal reference model in some studies), the primary tool of use since the 1980's. We then discuss some of the many applications of the DMM. Although the model was proposed to examine the effects of social mobility on outcomes of interest, the estimated relationships between mobility and outcomes that researchers have called mobility effects are more appropriately regarded as partial associations. When mobility is not associated with outcomes, as is often found in empirical work, the outcomes of movers from origin o to destination d are a weighted average of the outcomes of individuals who remained in states o and d respectively, and the weights capture the relative salience of origins and destinations in the acculturation process. In light of this attractive feature of the model, we briefly develop several generalizations of the current DMM that future researchers should also find useful. Finally, we propose new estimands of mobility effects, based on the explicit notion that a unit effect of mobility is a comparison of an individual with herself under two conditions, one in which she is mobile, the other in which she is immobile, and we discuss some of the challenges in identifying such effects.
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Affiliation(s)
- Emma Zang
- Department of Sociology, Yale University, USA.
| | | | - Liying Luo
- Department of Sociology and Criminology, Pennsylvania State University, USA
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Ramírez-Correa P, Grandón EE, Ramírez-Santana M, Arenas-Gaitán J, Rondán-Cataluña FJ. Explaining the Consumption Technology Acceptance in the Elderly Post-Pandemic: Effort Expectancy Does Not Matter. Behav Sci (Basel) 2023; 13:87. [PMID: 36829316 PMCID: PMC9952286 DOI: 10.3390/bs13020087] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 01/11/2023] [Accepted: 01/16/2023] [Indexed: 01/24/2023] Open
Abstract
Consumer technology has been enormously boosted by the COVID-19 pandemic, with one of the primary consumers being the elderly. In this scenario, it is necessary to consider the impact of technologies on different older generational cohorts to understand the future of a data-driven digital society fully. This research aims to explain the acceptance of social networking sites, a particular consumer technology, in the post-pandemic elderly population. Data were obtained from 1555 older adults in Chile based on a consumer technology acceptance model. The respondents were grouped according to their technological predisposition and their generation into three groups. Applying a multigroup analysis based on structural equation modelling reveals significant differences in the explanatory variables of the intention and use of this technology between the groups. And more remarkably, the effort expectancy is not statistically significant as a variable to explain this acceptance globally in either of the three groups. There are two principal contributions of this study. First, it shows why adults adopt consumer technology after the pandemic. Second, it validates a classification of elderly adults who use consumption technologies that are useful in understanding the heterogeneity of this phenomenon.
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Affiliation(s)
| | | | - Muriel Ramírez-Santana
- Public Health Department, Faculty of Medicine, Universidad Católica del Norte, Coquimbo 1781421, Chile
| | - Jorge Arenas-Gaitán
- Department of Business Administration and Marketing, Universidad de Sevilla, 41004 Sevilla, Spain
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Rodrigues WTDS, Simões TC, Magnago C, Dantas ESO, Guimarães RM, Jesus JCD, de Andrade Fernandes SMB, Meira KC. The influence of the age-period-cohort effects on male suicide in Brazil from 1980 to 2019. PLoS One 2023; 18:e0284224. [PMID: 37053241 PMCID: PMC10101429 DOI: 10.1371/journal.pone.0284224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 03/27/2023] [Indexed: 04/14/2023] Open
Abstract
Suicide is a complex and multi-determined phenomenon. Higher rates are observed in men and are related to multiple risk factors, including mental disorders, financial crises, unemployment, and easy access to highly lethal means of perpetration, such as firearms. We studied the effects of age, period, and cohort (APC) on total and firearm-related suicides in men in Brazil and its major regions from 1980 to 2019. Death records were extracted from the Brazilian Ministry of Health's Mortality Information System. Estimable functions were used to estimate APC models, through the Epi library of the R statistical program, version 4.2.1. During the study period, Brazil had an average rate of 10.22 deaths per 100,000 men. Among regions, rates ranged from 8.62 (Northeast) to 16.93 (South). The same profile was observed in suicides by firearms. After estimating the APC models, we observed a temporal trend of increasing total suicides for Brazil and regions, except for the South region, where the trend was stationary. The trend was downward for firearm suicides for all locations. A positive gradient was observed in the mortality rate with advancing age for total suicides; and peak incidence between 20-29 years, with subsequent stabilization, for suicides perpetrated by firearms. There was a reduction in the risk of death for suicides perpetrated by firearms in relation to the reference period (1995-1999) for all locations, except in the North region, where the effect was not significant. The younger generations from the 1960s onwards had a higher risk of death from total suicide and a lower risk for those perpetrated by firearms in relation to the reference cohort (1950-1954). We observed a reduction in the mortality trend for suicides perpetrated by firearms, a reduction in the risk of death in the 2000s and for men born after 1960. Our results suggest reducing the risk of death from suicide by firearms in Brazil and regions. However, there is an upward trend in mortality from total suicides in the study period (1980-2019) and for younger cohorts.
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Affiliation(s)
| | - Taynãna César Simões
- René Rachou Research Institute, Oswaldo Cruz Foundation of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Carinne Magnago
- School of Public Health, University of São Paulo, São Paulo, Brazil
| | | | | | | | | | - Karina Cardoso Meira
- School of Health, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
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Luo L, Zang E, Xu J. Regional differences in intercohort and intracohort trends in obesity in the USA: evidence from the National Health Interview Survey, 1982-2018. BMJ Open 2022; 12:e060469. [PMID: 35906048 PMCID: PMC9345057 DOI: 10.1136/bmjopen-2021-060469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 07/06/2022] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES Obesity in the USA is more prevalent in younger cohorts than older cohorts and also more prevalent in the South and the Midwest than other regions. However, little research has examined the intersection of cohort patterns and regional differences in obesity. We address the knowledge gap by investigating net of age and period trends, how intercohort and intracohort patterns in obesity may depend on Census regions for black and white men and women. DESIGN, SETTING AND PARTICIPANTS A total of 1 020 412 non-Hispanic black and white respondents aged 20-69 were included from the 1982-2018 National Health Interview Survey. OUTCOME MEASURES Obesity is defined as body mass index ≥30 kg/m2 based on participant self-reported weight and height. Obesity ORs were calculated to estimate region-specific age, period and cohort patterns for each demographic group. RESULTS Although age and period trends in obesity were similar across regions for all demographic groups, cohort patterns depended on region of residence for white women. Specifically, for the white women cohorts born in 1955 or later, living in the South and the Midwest implied higher likelihood of obesity than their peers in other regions even after accounting for average regional differences. These cohorts' disadvantage seemed to persist and/or accumulate over the life course. Socioeconomic factors explained little average regional differences or region-specific cohort variation. CONCLUSIONS Our findings highlight the interdependence of the temporal and geographical processes in shaping obesity disparities.
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Affiliation(s)
- Liying Luo
- Department of Sociology and Criminology, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Emma Zang
- Department of Sociology, Yale University, New Haven, Connecticut, USA
| | - Jiahui Xu
- Department of Sociology and Criminology, The Pennsylvania State University, University Park, Pennsylvania, USA
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10
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Rising childhood income inequality and declining Americans' health. Soc Sci Med 2022; 303:115016. [PMID: 35567904 PMCID: PMC9750155 DOI: 10.1016/j.socscimed.2022.115016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 04/05/2022] [Accepted: 05/04/2022] [Indexed: 12/16/2022]
Abstract
Morbidity and mortality are on the rise among Baby Boomers and younger cohorts. This study investigates whether this unfavorable health trend across birth cohorts 1925-1999 is related to rising income inequality Americans face during childhood. We use two nationally representative datasets: National Health and Nutrition Examination Surveys (NHANES) 1988-2018 and Panel Studies of Income Dynamics (PSID) 1968-2013, and two health outcomes: biomarkers of physiological dysregulation, and a chronic disease index. Childhood income inequality is measured by the average of the Gini index at the national level each birth cohort is exposed to between birth and age 18, where the Gini index from 1925 to 2016 is computed based on Internal Revenue Service income data. By merging childhood income inequality to individual level data from NHANES or PSID based on birth cohort, we find childhood income inequality is positively associated with the risk of physiological dysregulation in adulthood for all gender and racial groups in the NHANES data. It is also significantly related to the risk of chronic disease in the PSID data. This association is robust to controls for individual level childhood health and family background, adulthood socioeconomic and marital status, and contemporary macro socioeconomic factors. More importantly, childhood income inequality exposure explains a substantial amount of variation in these two health outcomes across cohorts, a pattern not observed for other early life exposures that display negative temporal trends similar to those for childhood income inequality. This study provides important evidence that income inequality experienced during childhood may have a long-lasting negative consequence for adult health, which partially explains the adverse health trends experienced by Baby Boomers and younger cohorts in the United States.
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11
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Odd D, Williams T, Appleby L, Gunnell D, Luyt K. Child suicide rates during the COVID-19 pandemic in England. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2021; 6:100273. [PMID: 34841386 PMCID: PMC8604801 DOI: 10.1016/j.jadr.2021.100273] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 11/15/2021] [Accepted: 11/16/2021] [Indexed: 01/31/2023] Open
Abstract
Background There is concern about the impact of COVID-19, and the control measures to prevent the spread, on children's mental health. The aim of this work was to identify if there had been a rise of childhood suicide during the COVID pandemic. Method Using data from England's National Child Mortality Database (NCMD) the characteristics and rates of children dying of suicide between April and December 2020 were compared with those in 2019. In a subset (1st January to 17th May 2020) further characteristics and possible contributing factors were obtained. Results A total of 193 likely childhood deaths by suicide were reported. There was no evidence overall suicide deaths were higher in 2020 than 2019 (RR 1.09 (0.80-1.48), p = 0.584) but weak evidence that the rate in the first lockdown period (April to May 2020) was higher than the corresponding period in 2019 (RR 1.56 (0.86-2.81), p = 0.144). Characteristics of individuals were similar between periods. Social restrictions (e.g. to education), disruption to care and support services, tensions at home and isolation appeared to be contributing factors. Limitations As child suicides are fortunately rare, the analysis is based on small numbers of deaths with limited statistical power to detect anything but major increases in incidence. Conclusion We found no consistent evidence that child suicide deaths increased during the COVID-19 pandemic although there was a possibility that they may have increased during the first UK lockdown. A similar peak was not seen during the following months, or the second lockdown.
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Affiliation(s)
- David Odd
- School of Medicine, Division of Population Medicine, Cardiff University, UK.,National Child Mortality Database, Bristol Medical School, University of Bristol, St Michael's Hospital, Southwell Street, Bristol, UK
| | - Tom Williams
- National Child Mortality Database, Bristol Medical School, University of Bristol, St Michael's Hospital, Southwell Street, Bristol, UK
| | - Louis Appleby
- Division of Psychology & Mental Health, University of Manchester, UK
| | - David Gunnell
- NIHR Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust, University of Bristol, Bristol, UK
| | - Karen Luyt
- National Child Mortality Database, Bristol Medical School, University of Bristol, St Michael's Hospital, Southwell Street, Bristol, UK
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12
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Zheng H, Echave P. Are Recent Cohorts Getting Worse? Trends in US Adult Physiological Status, Mental Health, and Health Behaviors Across a Century of Birth Cohorts. Am J Epidemiol 2021; 190:2242-2255. [PMID: 33738469 DOI: 10.1093/aje/kwab076] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 03/11/2021] [Accepted: 03/15/2021] [Indexed: 12/13/2022] Open
Abstract
Morbidity and mortality have been increasing among middle-aged and young-old Americans since the turn of the century. We investigated whether these unfavorable trends extend to younger cohorts and their underlying physiological, psychological, and behavioral mechanisms. Applying generalized linear mixed-effects models to data from 62,833 adults from the National Health and Nutrition Examination Surveys (1988-2016) and 625,221 adults from the National Health Interview Surveys (1997-2018), we found that for all sex and racial groups, physiological dysregulation has increased continuously from Baby Boomers through late-Generation X and Generation Y. The magnitude of the increase was higher for White men than for other groups, while Black men had a steepest increase in low urinary albumin (a marker of chronic inflammation). In addition, Whites underwent distinctive increases in anxiety, depression, and heavy drinking, and they had a higher level than Blacks and Hispanics of smoking and drug use in recent cohorts. Smoking is not responsible for the increasing physiological dysregulation across cohorts. The obesity epidemic contributes to the increase in metabolic syndrome but not in low urinary albumin. The worsening physiological and mental health profiles among younger generations imply a challenging morbidity and mortality prospect for the United States, one that might be particularly inauspicious for Whites.
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13
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Zang E, Kim N. Intergenerational upward mobility and racial differences in mortality among young adults: Evidence from county-level analyses. Health Place 2021; 70:102628. [PMID: 34280713 PMCID: PMC8328956 DOI: 10.1016/j.healthplace.2021.102628] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 07/12/2021] [Accepted: 07/13/2021] [Indexed: 11/21/2022]
Abstract
Inspired by the influential "deaths of despair" narrative, which emphasizes the role of worsening economic opportunity in driving the increasing mortality for non-Hispanic Whites in the recent decades, a rising number of studies have provided suggestive evidence that upward mobility levels across counties may partly explain variations in mortality rates. A gap in the literature is the lack of life-course studies examining the relationship between early-life upward mobility and later-life mortality across counties. Another gap is the lack of studies on how the relationship between upward mobility and mortality across counties varies across diverse sociodemographic populations. This study examines differences across race and sex in the relationship between early-life intergenerational upward mobility and early adulthood mortality at the county level. We use administrative data on upward mobility and vital statistics data on mortality across 3030 counties for those born between 1978 and 1983. We control for a variety of county-level socioeconomic variables in a model with fixed effects for state and year. Subgroup analyses by educational attainment and urban status were also performed for each race-sex combination. Results show strong negative relationships between early-life upward mobility and early adulthood mortality across racial-sex combinations, with a particularly greater magnitude for non-Hispanic Black males. In addition, individuals without a college degree and living in urban counties are particularly affected by early life upward mobility. The findings of this study highlight the vulnerability of less-educated, young urban Black males, due to the intersecting effects of the urban context, education, race, and sex.
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Affiliation(s)
- Emma Zang
- Department of Sociology, Yale University, New Haven, CT, USA.
| | - Nathan Kim
- Institution for Social and Policy Studies, Yale University, New Haven, CT, USA
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14
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Cao C, Yang L, Cade WT, Racette SB, Park Y, Cao Y, Friedenreich CM, Hamer M, Stamatakis E, Smith L. Cardiorespiratory Fitness Is Associated With Early Death Among Healthy Young and Middle-Aged Baby Boomers and Generation Xers. Am J Med 2020; 133:961-968.e3. [PMID: 32006474 DOI: 10.1016/j.amjmed.2019.12.041] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 12/02/2019] [Accepted: 12/04/2019] [Indexed: 01/13/2023]
Abstract
BACKGROUND Increased mortality associated with low cardiorespiratory fitness has shown to take effect during late adulthood in previous generations. A recent rise in early death was observed in the United States. We investigated the impact of low cardiorespiratory fitness during young and middle adulthood on premature death in healthy adults from recent generations. METHODS A prospective cohort study of a nationally representative sample of US Baby Boomers and Generation Xers (born 1945-1980). Between 1999 and 2004, 3242 adults ages 20 to 49 years (weighted N = 59,888,450; mean age, 33.8 ± 0.2 years) underwent submaximal treadmill exercise test in the National Health and Nutrition Examination Survey study. Weighted Cox proportional hazards regression were used to evaluate the association of cardiorespiratory fitness with premature death at 65 years or younger. RESULTS During a mean follow-up of 13.8 years, 104 deaths (weighted deaths N =1,326,808) occurred. Low cardiorespiratory fitness was associated with an increased risk of premature death as a result of all-cause (hazard ratio [HR], low vs high: 2.26; 95% confidence interval [CI], 1.10 to 4.64, P for trend = 0.036) and cancer mortality (HR low vs moderate/high: 6.53; 95% CI, 2.38 to 17.9). Further, this association was stronger in adults ages 35 to 49 years at baseline (HR, 4.17 [95% CI, 1.19 to 9.11]). CONCLUSION We observed an inverse association between cardiorespiratory fitness during middle adulthood and premature death, which was not detected in preceding generations. These findings suggested that low cardiorespiratory fitness might be emerging as a new risk factor for early death among US Baby Boomers and Generation Xers.
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Affiliation(s)
- Chao Cao
- Program in Physical Therapy and Department of Medicine, Washington University School of Medicine, St Louis, MO; Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St Louis, MO.
| | - Lin Yang
- Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Calgary, AB, Canada; Departments of Oncology and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - W Todd Cade
- Program in Physical Therapy and Department of Medicine, Washington University School of Medicine, St Louis, MO
| | - Susan B Racette
- Program in Physical Therapy and Department of Medicine, Washington University School of Medicine, St Louis, MO
| | - Yikyung Park
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St Louis, MO; Siteman Cancer Center, Washington University School of Medicine, St Louis, MO
| | - Yin Cao
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St Louis, MO; Siteman Cancer Center, Washington University School of Medicine, St Louis, MO
| | - Christine M Friedenreich
- Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Calgary, AB, Canada; Departments of Oncology and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Mark Hamer
- Division Surgery & Interventional Science, University College London, UK
| | - Emmanuel Stamatakis
- Charles Perkins Centre and Prevention Research Collaboration, Sydney School of Public Health, The University of Sydney, Australia
| | - Lee Smith
- The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, UK
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Zheng H. A New Look at Cohort Trend and Underlying Mechanisms in Cognitive Functioning. J Gerontol B Psychol Sci Soc Sci 2020; 76:1652-1663. [PMID: 32726439 DOI: 10.1093/geronb/gbaa107] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVES The prevalence of dementia in the United States seems to have declined over the last few decades. We investigate trends and their underlying mechanisms in cognitive functioning (CF) across 7 decades of birth cohorts from the Greatest Generation to Baby Boomers. METHODS Data come from 30,191 participants of the 1996-2014 Health and Retirement Study. CF is measured as a summary score on a 35-point cognitive battery of items. We use generalized linear models to examine the trends in CF and explanatory variables across birth cohorts. Then, Karlson-Holm-Breen decomposition method is used to evaluate the contribution of each explanatory variable to the trend of CF. RESULTS CF has been improving from the Greatest Generation to Late Children of Depression and War Babies, but then significantly declines since the Early-Baby Boomers and continues into Mid-Baby Boomers. This pattern is observed universally across genders, race/ethnicities, education groups, occupations, income, and wealth quartiles. The worsening CF among Baby Boomers does not originate from childhood conditions, adult education, or occupation. It can be attributed to lower household wealth, lower likelihood of marriage, higher levels of loneliness, depression and psychiatric problems, and more cardiovascular risk factors (e.g., obesity, physical inactivity, hypertension, stroke, diabetes, and heart disease). DISCUSSION The worsening CF among Baby Boomers may potentially reverse past favorable trends in dementia as they reach older ages and cognitive impairment becomes more common if no effective interventions and policy responses are in place.
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Affiliation(s)
- Hui Zheng
- Department of Sociology, Institute for Population Research, The Ohio State University, Columbus
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16
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Abstract
Importance US life expectancy has not kept pace with that of other wealthy countries and is now decreasing. Objective To examine vital statistics and review the history of changes in US life expectancy and increasing mortality rates; and to identify potential contributing factors, drawing insights from current literature and an analysis of state-level trends. Evidence Life expectancy data for 1959-2016 and cause-specific mortality rates for 1999-2017 were obtained from the US Mortality Database and CDC WONDER, respectively. The analysis focused on midlife deaths (ages 25-64 years), stratified by sex, race/ethnicity, socioeconomic status, and geography (including the 50 states). Published research from January 1990 through August 2019 that examined relevant mortality trends and potential contributory factors was examined. Findings Between 1959 and 2016, US life expectancy increased from 69.9 years to 78.9 years but declined for 3 consecutive years after 2014. The recent decrease in US life expectancy culminated a period of increasing cause-specific mortality among adults aged 25 to 64 years that began in the 1990s, ultimately producing an increase in all-cause mortality that began in 2010. During 2010-2017, midlife all-cause mortality rates increased from 328.5 deaths/100 000 to 348.2 deaths/100 000. By 2014, midlife mortality was increasing across all racial groups, caused by drug overdoses, alcohol abuse, suicides, and a diverse list of organ system diseases. The largest relative increases in midlife mortality rates occurred in New England (New Hampshire, 23.3%; Maine, 20.7%; Vermont, 19.9%) and the Ohio Valley (West Virginia, 23.0%; Ohio, 21.6%; Indiana, 14.8%; Kentucky, 14.7%). The increase in midlife mortality during 2010-2017 was associated with an estimated 33 307 excess US deaths, 32.8% of which occurred in 4 Ohio Valley states. Conclusions and Relevance US life expectancy increased for most of the past 60 years, but the rate of increase slowed over time and life expectancy decreased after 2014. A major contributor has been an increase in mortality from specific causes (eg, drug overdoses, suicides, organ system diseases) among young and middle-aged adults of all racial groups, with an onset as early as the 1990s and with the largest relative increases occurring in the Ohio Valley and New England. The implications for public health and the economy are substantial, making it vital to understand the underlying causes.
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Affiliation(s)
- Steven H Woolf
- Center on Society and Health, Department of Family Medicine and Population Health, Virginia Commonwealth University School of Medicine, Richmond
| | - Heidi Schoomaker
- Center on Society and Health, Virginia Commonwealth University School of Medicine, Richmond
- Now with Eastern Virginia Medical School, Norfolk
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17
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APC curvature plots: Displaying nonlinear age-period-cohort patterns on Lexis plots. DEMOGRAPHIC RESEARCH 2019. [DOI: 10.4054/demres.2019.41.42] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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